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Outcomes at a glance

Findings
In the original evaluation phase of the project:

  • A quarter of patients had a BMI ≥ 40kg/m2
  • 76% had at least one obesity related co-morbidity
  • 47% were classified as ‘high attenders’ in that they attended more than 2/3rds of the planned appointments
  • Mean weight change at 12 months was -3.0kg in all patients (n=642, p<0.001) and -4.3kg in high attenders (n=422, p<0.001)
  • At 24 months weight change was -2.3kg in all patients (n=357, p<0.001) and -3.3kg in high attenders (n=225, p<0.001)
  • Target weight loss of ≥5% loss at 12 months was achieved in one third of all patients enrolled in the programme
  • Obesity-related cardiovascular disease (CVD) risk factors improved in the whole cohort
  • 67.4% of patients who attended follow up at 12 months had lost weight compared with baseline and 3.7% were weight stable

Data from the Scottish Government funded implementation
The Scottish Government commissioned three phases of Counterweight implementation commencing 2006.  The first two phases linked the Counterweight Programme to a primary care cardiovascular disease prevention programme; the third phase was commissioned independent of other interventions.

  • As of November 2010, 6715 patients from 184 general practices, 16 pharmacies and one centralized community-based service in 13 Health Boards, with a mean BMI of 37 30 kg/m2 were enrolled in the Counterweight Programme
  • Twenty-six per cent had a BMI > 40kg/m2
  • Attendance for patients at 3, 6 and 12 months follow-up was 55%, 37% and 28%
  • Of those who attended at 12 months, 35.2% had maintained a weight loss of >5% compared to 30.7% in the original evaluation (ref: link to publications section website)
  • Evaluation of the Counterweight Programme in Scotland demonstrated consistency in characteristics of patients enrolled into the programme
  • There was evidence of higher loss to follow-up in a population not routinely engaging with primary care but evidence of greater weight losses among those who attended

Counterweight Plus
This programme was evaluated in a feasibility study assessing the role for a year-long primary care programme commencing with a total diet replacement of 810kcal and followed up with stepped food reintroduction and weight loss maintenance.

  • 62% of patients with an initial BMI of >40kg/m2 completed the liquid diet phase and achieved a mean weight-loss of 17.4 kg
  • At 12 months the mean loss of the 75% with follow up weight was 12.4kg
  • The target loss of >15kg at 12 months was reached by over a third of all patients entered and almost half of those with follow up weight record at that time point
  • 12 month results are in the process of publication and have been presented at ECO May 2012 as a poster presentation (refer to publication section on website)